Health & Social Care A clean bill of health
In the biggest shake-up of the NHS since its inception, 151 primary care trusts (PCTs) and 10 strategic health authorities will go and 24,500 manager posts will be lost. The reforms are expected to cost £1.4bn to implement according to government estimates (others have said nearer £3bn), but are expected to save £5bn by the end of 2014/15, principally through a 33% saving in administrative costs. The government’s “pause and listen” exercise during June resulted in some cosmetic changes to the Bill, but the broad thrust of the proposals remains the same.
And change is already underway, even before the ink dries on the Bill. In future, it will be lean and nimble providers who prosper. They will need to know how to design services which appeal to new “customers”—clinical commissioning
groups (CCGs) led and
owned by GPs but with representation on their board from nurses, hospital doctors and lay members, the NHS commissioning board and its regional outposts based initially on clusters of PCTs, local authorities, who have a new duty to improve public health, and of course increasingly savvy personal budget- holding patients and service users.
Equity & excellence: liberating the NHS Key
themes of the White Paper preceded the Bill were: which
More autonomy—less bureaucracy. The Bill gives this principle legislative force—requiring the secretary of state to promote autonomy by giving NHS bodies and professionals freedom to exercise their functions in the most appropriate manner and by not imposing unnecessary burdens on them.
More competition and choice—a more diverse range of providers. “Any qualifi ed provider” of a service should be able to compete on a level playing fi eld.
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